Author:
Arendrup Maiken Cavling,Rodriguez-Tudela Juan-Luis,Park Steven,Garcia-Effron Guillermo,Delmas Guillaume,Cuenca-Estrella Manuel,Gomez-Lopez Alicia,Perlin David S.
Abstract
ABSTRACTThe MICs of echinocandins againstCandidaisolates withfksmutations are higher than those for wild-type (WT) isolates. However, the MIC ranges for susceptible and mutant populations overlap or are poorly separated. It was recently reported that a greater separation could be achieved in the presence of serum. To more fully explore this possibility, we compared the performances of the reference microdilution methods by using standard and bovine serum albumin (BSA)-supplemented growth medium. Anidulafungin, caspofungin, and micafungin MICs were determined according to EUCAST and CLSI methods and with 50% BSA in the medium for 93 clinical isolates, includingCandida albicans(20/10 [number of isolates/number of mutants]),C. glabrata(19/10),C. dubliniensis(2/1),C. krusei(16/3),C. parapsilosis(19), andC. tropicalis(19/4) isolates. Stability of the plates was tested after storage at −80°C for 2 and 6 months, and the performance of two different lots of caspofungin was investigated. The addition of BSA to the medium resulted in higher MICs (1 to 9 2-fold dilution steps) for all isolates and compounds. The increases were greatest for anidulafungin and micafungin and, among WT isolates, forC. parapsilosis. The number of very major errors (VMEs) was reduced (24% [20/84 isolates] versus ≤7% [6/84 isolates]) using BSA-supplemented EUCAST medium but not using BSA-supplemented CLSI medium (6% versus 9%). MIC results were unchanged after 6 months of storage of test plates. The two lots of caspofungin yielded identical results. Addition of BSA to the EUCAST medium increases the ability to differentiate between WT isolates and isolates harboring resistance mutations.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
50 articles.
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